Page 950 - Saunders Comprehensive Review For NCLEX-RN

a. Restore circulating blood volume, and
protect against cerebral, coronary, or
renal hypoperfusion.
b. Correct dehydration with IV infusions
of 0.9% or 0.45% saline as prescribed.
c. Correct hyperglycemia with IV regular
insulin administration as prescribed.
d. Monitor vital signs, urine output, and
mental status closely.
e. Correct acidosis and electrolyte
imbalances as prescribed.
f. Administer oxygen as prescribed.
g. Monitor blood glucose level frequently.
h. Monitor potassium level closely,
because when the child receives
insulin to reduce the blood glucose
level, the serum potassium level
changes; if the potassium level
decreases, potassium replacement may
be required.
i. The child should be voiding adequately
before administering potassium; if the
child does not have an adequate
output, hyperkalemia may result.
j. Monitor the child closely for signs of
fluid overload.
k. IV dextrose is added as prescribed
when the blood glucose reaches an
appropriate level.
l. Treat the cause of hyperglycemia.

Priority Nursing Actions

Hypoglycemia in a Hospitalized Child with
Diabetes Mellitus
1. Check the child’s blood glucose level.
2. Give the child ½ cup of fruit juice or other
acceptable item.
3. Take the child’s vital signs.
4. Retest the blood glucose level.
5. Give the child a small snack of carbohydrate
and protein.
6. Document the child’s signs and symptoms,
actions taken, and outcome.

Reference

Hockenberry. Wilson, Rodgers. 2017;292–294.

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